Closing the health care gap in rural America
Approximately 60 million Americans live in a rural area, and these individuals and families face a striking health gap compared to urban residents. According to the Centers for Disease Control and Prevention, rural residents are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than those living in urban areas.
That’s because rural residents tend to be older and sicker than their urban counterparts, and rates of cigarette smoking, high blood pressure and obesity tend to be higher. Because it can be hard to get care, health problems may be more serious by the time they are diagnosed. In rural areas the patient to primary care physician ratio is 39.8 physicians per 100,000 people, compared to 53.3 per 100,000 in urban areas impacting the health of the population.
There is no single solution to this web of complex health care challenges. What’s clear is that deep community roots and tailored, local solutions can help close the care gap for residents in rural America.
In North Carolina, where roughly 40 percent of the state’s population lives in a rural area, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is investing $8 million to address the unique health challenges of rural communities. Rural residents in the state have higher rates of drug and alcohol use, suicide, injury and teenage birth; and they are also more likely to be uninsured or underinsured.
Blue Cross NC’s investment funds eight programs uniquely positioned to improve health within the rural areas they serve—from fighting the opioid epidemic to improving access to care and making communities safer. Funding will expand quality health care programs to improve care delivery, increase health-centered home repairs, expand access to Naloxone/Narcan for EMS first responders to prevent overdose deaths, provide scholarships to more than 4,000 community college students as well as additional scholarship money for community college transfer students, and increase interpersonal violence screening for families experiencing domestic violence.
Premera Blue Cross is supporting the creation of a pipeline of nurse practitioners in rural communities through the Rural Nursing Health Initiative spearheaded by the University of Washington School of Nursing. Investing $4.7 million in the program, set to run over a four-year period and support 20 students per year, the collaboration is part of a larger plan to improve access to care in rural areas. Premera is focusing on investing in physician, nurse and health aide recruitment and training; clinical integration of behavioral health; provider to provider consultations to support isolated rural doctors; and programs to increase the capacity of mental health crisis centers in rural areas.
In Alabama, where nearly a quarter of the state’s population lives in a rural area, Blue Cross and Blue Shield of Alabama (BCBS AL) is working to expand access to quality and innovative care through a series of initiatives and investments. The Enhanced Patient Care program supports hospitals implementing innovative solutions to improve care encourages the sharing of approaches to allow other hospitals to better understand and implement best practices.
In 2019, BCBS AL began piloting urgent care programs in several rural hospitals, reducing out-of-pocket costs for members and bringing urgent care closer to home for residents. They are investing in the future of their primary care physician network with $11 million in medical scholarships for students agreeing to practice as a primary care or behavioral physician in an underserved area in the state.
Through a U.S. Department of Agriculture grant, BCBS AL is partnering with the University of Alabama at Birmingham to establish telemedicine carts in rural hospitals, allowing patients improved access to specialists. BCBS AL also sponsors health fairs at local hospitals, giving community members access to recommended wellness screenings and educational opportunities close to home.
The widening rural-urban disparities in health and life expectancy mean that it is more important than ever to focus on solutions that close rural health care gaps. Geography shouldn’t be a barrier to better health.
